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Invited Critique
January 1999

Invited Critique: Laparoscopic Splenectomy

Arch Surg. 1999;134(1):103. doi:10.1001/archsurg.134.1.103

Different techniques of laparsocopic splenectomy have been described previously. Drs Schlinkert and Teotia provide us with a concise presentation of their version of it. Clearly one technique does not apply to spleens of all sizes and types of anatomy.

Lessons learned from other laparoscopic operations should be applied to splenectomy as well. Anytime an operation traditionally performed using the open technique is approached laparoscopically, one should make every effort not to alter the key components of the operation. In the current report, an en masse ligation of the splenic artery and vein using a stapling device is recommended. This approach is only acceptable if the surgeon routinely does not identify and ligate the splenic artery and vein separately during open splenectomy. Additionally, the authors suggest division of the "massive" spleen into pieces within the peritoneal cavity to facilitate its retrieval. This maneuver clearly violates the principles of oncologic surgery and should rarely be considered.

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